The goal of this research proposal is to expand knowledge of work organizational and psychosocial risk factors for stress-related and musculoskeletal occupational illness. The proposal is based on analyses of a large data base collected in the Netherlands. The data base, entitled the Monitor Study, is constructed from a representative sampling of employers and employees in 782 companies (7717 employees). This study represents the best source of currently available data for addressing the goal and specific aims of this proposal. The project consists of a multilevel examination and characterization of the associations between organization-level characteristics, individual-level psychosocial and physical stressors, intermediate measures of musculoskeletal and psychological strain and the health-related outcomes of musculoskeletal and stress-related absenteeism and disability. The Monitor data base will allow construction of measures and scales that represent each of these aspects. The research will examine three interrelated hypotheses: 1. Shop floor-level psychosocial stressors are associated with adverse outcomes of musculoskeletal and psychological strain, musculoskeletal and stress-related illness, absenteeism and disability; 2. Characteristics of organizational structure and culture are associated with the individual-level psychosocial stressors; and 3. These organization-level characteristics also have direct associations with the individual-level outcome variables of hypothesis 1. The specific aims are sequential, relating to the three hypotheses. For each hypothesis the investigators intend to: a)construct measures and scales that represent the different aspects of the model, b) test these measures for internal consistency and external comparability with other studies, c) use the measures to test the initial model, and d) alter the model, construct new measures and generate new hypotheses if required by the data. This research represents an important opportunity to move beyond the measurement of individual-level risk factors to the difficult characterization of organizational-level effects on individual health outcomes. By focusing on measures of organization-level structure and culture, this research will generate new information about the etiology of disease and its relationship to both individual and larger organizational influences. The results will expand information that can be used to prioritize and guide future organization-level intervention strategies.